Active NPI
Juanita Christian Thomas, PHYSICAL THERAPY LIC
- Pediatric Physical Therapist
- Florence, SC
National Provider Identifier
1265601660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 586
- Practice address
- 2005 Tobin Dr
Florence, SC 29501-1434 - Phone
- (843) 662-4499
- NPI assigned
- Feb 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 586 | SC | Primary |
Addresses
Primary practice location
2005 Tobin Dr
Florence, SC 29501-1434
Mailing address
2005 Tobin Dr
Florence, SC 29501-1434
Phone (843) 662-4499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH0094 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 586 | SC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1265601660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 TOBIN DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295011434",
"telephone_number": "843-662-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 TOBIN DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295011434",
"telephone_number": "843-662-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JUANITA",
"middle_name": "CHRISTIAN",
"name_prefix": "Mrs.",
"credential": "PHYSICAL THERAPY LIC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-29",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "SC",
"license": "586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH0094",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.